Godfreyupchurch8190

A 74-year-old male patient with stage D1 prostate cancer with the initial prostate-specific antigen (PSA) level of 5570 ng/mL had received androgen deprivation therapy and the serum PSA level had decreased to 0.23 ng/mL when he developed macroscopic hematuria. MRI and cystoscopy suggested invasive urothelial cancer of the bladder, and transurethral resection was performed. The tumors were pathologically diagnosed as a Gleason score 9 prostate cancer with no PSA expression. Prostate cancer patients who develop novel symptoms should be screened for prostate cancer recurrence even if they have very low PSA levels.Angiomyolipoma (AML) is a benign renal mesenchymal tumor. Active surveillance is considered the most appropriate option for most AMLs. The major complication of AML is its spontaneous bleeding in the retroperitoneum that could be life-threatening for the patient. In this case, acute bleeding from a sporadic AML was reported immediately after the induction of a 12 mmHg pneumoperitoneum during a planned laparoscopic resection of the rectum for oncological reasons. After immediate stabilization the patient underwent angiography of the renal artery and super-selective vascular embolization. Although rare, spontaneous rupture of asymptomatic AML should always be considered, especially in intraoperative setting.Epithelial-myoepithelial carcinoma (EMC) of the penis is a rare malignant tumor which has not previously been described in the literature. Genetic associations exist in EMC that could potentially help guide early diagnosis and treatment of this type of penile cancer. This serves as the first reported case of such cancer of the penis, and highlights the indolent course it takes to presentation, and the need for an appropriate histopathologic evaluation for the correct diagnosis.Calcifying fibrous tumor of the tunica vaginalis is a rare fibrous proliferation, which can sometimes mimic a scrotal malignancy prompting surgical intervention. It has been recognized as a benign lesion, and no recurrence has been described after its resection. Its identification is essential to avoid overtreatment and unnecessary orchiectomy. We herein describe a rare case of calcifying fibrous tumor of the tunica vaginalis in a young patient and review the clinical features of inguinal and scrotal calcifying fibrous tumors to help clinical decisions and encourage a testis sparing surgery.Percutaneous nephrolithotomy (PCNL) is one of the important options in the management of large (>2 cms) and complex renal calculi. Traditionally the prone position has been used to access the pelvicaliceal system. It has its advantages and disadvantages as well. Several modifications to this position have been suggested and reported by several urologists. We had performed PCNL in an elderly female in classical prone position with severe kyphoscoliosis and solitary functioning kidney.Paratesticular liposarcomas are uncommon malignancies, often misdiagnosed preoperatively, that present as a painless scrotal mass. There is no universal consensus on their management due to scarcity of reported cases. Early detection and prompt surgical intervention provide the best disease outcome. We present the case of a 74-year-old man with a painless left testicular mass. Ultrasound and CT scan showed a paratesticular tumour. He underwent left high inguinal orchidectomy. Histopathological, immunohistochemical and cytogenetics studies confirmed the diagnosis of a Grade 2 well differentiated paratesticular liposarcoma with clear surgical margins. The case was referred to our regional sarcoma centre and currently undergoes regular follow-up.Plasmacytoid urothelial carcinoma (PUC) is a rare variant of bladder cancer characterized by distinct histopathology and advanced stage at diagnosis. Multimodal treatment is usually indicated. We present a case of PUC causing bilateral ureteral obstruction with subsequent renal failure followed shortly by malignant small bowel obstruction, demonstrating the need for a high degree of clinical suspicion in diagnosis of this aggressive subtype. Moreover, the local invasiveness of the disease cannot be understated, given that it can rapidly spread with little radiologic evidence of progression until it is at an advanced stage.Oncologic recurrence can occur after Robot-Assisted Radical Prostatectomy. Prostate cancer metastasizes often in bones, however the peritoneum is infrequently targeted. Even more, peritoneal dissemination without any other organ involved especially the bones is very rare, only few cases are reported. Through the available literature we discuss about the presumed seeding theory leading to this atypical location for prostatic metastases. Here we report a case of isolated non-ascitic prostatic peritoneal metastases most probably due to iatrogenic spillage during surgery.Tuberous sclerosis complex has several renal manifestations like angiomyolipomas. We report a case of a giant AML and discuss its diagnosis and treatment. A 42-year-old woman was admitted to emergency department due to flank pain and hematuria. The patient had history of mental retardation and epilepsy. Abdominal CT without contrast medium revealed a large mass with a fat/blood content inside. On those findings, we diagnosed the patient a bleeding giant AML. We performed selective embolization of the bleeding source with subsequent conservative management. TSC-associated AMLs occur more frequently as multiple lesions and grow to larger size than idiopathic AML.We report a case of spontaneous bladder rupture due to bladder carcinoma. A 52-year-old female presented in septic shock, and computed tomography revealed free air in the subphrenic space and a mass in the middle of the pelvis. selleck inhibitor The exploratory laparotomy helped to confirm a definitive diagnosis bladder rupture due to bladder carcinoma. She underwent a radical cystectomy and survived. Surgical intervention is recommended to manage carcinomatous bladder rupture. Timely and accurate diagnosis is essential to optimize the patient's outcomes. The possibility of spontaneous bladder rupture should not be overlooked as a differential diagnosis in cases of the acute abdomen.